Southbridge chases ambulance transfer fees

Friday

Feb 22, 2013 at 8:00 PMFeb 22, 2013 at 9:26 PM

By Brian Lee TELEGRAM & GAZETTE STAFF

Town Manager Christopher Clark, Fire Chief Mark W. DiFronzo and firefighter union leaders will meet Tuesday to come up with a plan to cash in on the increased number of ambulance transfer opportunities from Harrington Hospital.

Like the department heads, Firefighter Derek Lamica, president of the union, said town ambulance runners want to take on more transfers. But there appears to be disagreement between the two sides about how this should be accomplished.

The hospital system's growth has created opportunities for Fire Department ambulance workers to conduct more transfers.

A hospital spokesman said Harrington could not provide statistics on the number of transfer requests made to area communities.

Chief DiFronzo said he is compiling data that will be available at the meeting. The stats will encompass ambulance transfer requests made by the hospital and granted by the town from about October to Feb. 22.

Chief DiFronzo said Harrington has increasingly requested ambulance transfers for various reasons: taking patients to a long-term care facility, or back to their homes, or to another hospital for a higher level of care, or for continued care with their physicians. In some cases an insurance company has moved a patient to a facility with which it is affiliated.

Transfers are a money-making proposition.

Southbridge has made about $900,000 a year from ambulance runs the last couple of years, Mr. Clark said.

The Fire Department's annual budget is about $2 million. The town's budget is $54 million.Workers are paid a minimum of three hours in overtime for an ambulance transfer, said the chief, who has been in the job since July.

The department has three ambulances. There are 25 rank-and-file firefighters. Excepting the fire inspector, who works a conventional Monday-through-Friday day shift, firefighters work eight 24-hour shifts during the month, the chief said.

Six firefighters are staffed per shift. The 24-hour staffing adds to the complexity of fulfilling transfer requests.

Some firefighters have second jobs because they wanted a consistent means of second income, the chief said.

With the transfer work being sporadic and inconsistent, he said, firefighters can't plan their days or their times off around “a maybe.”

The other piece is that the all-day shifts can be grueling, the chief said. There were 27 calls during a single shift last month, he said.

Mr. Lamica said the department had resolved this issue when it had dedicated two firefighters to work conventional daytime shifts for ambulance calls.

But two firefighters have left the department, and the town has since stopped deploying the daytime shifts, he said.

“We never got a chance to let the program actually work,” he said.

Mr. Lamica said restoring two dayside workers would cover most calls from Harrington, and the money made from the transfers would easily offset their salaries.

“Harrington is putting out so many calls, we would never be able to cover them all,” he said.

Mr. Lamica said there are times all three ambulances are out on emergency calls, and “stripping the town” of emergency response to do transfers was not in its best interest.

“It's just not going to happen. The taxpayers are paying to have us there as emergency service,” he said.

The town manager said the two positions to which Mr. Lamica referred was a temporary, “test model” arrangement during which the two worked 12-hour shifts for three or four months. Their primary responsibility was to take additional ambulance calls.

While the town did see additional ambulance revenue during that time, Mr. Clark said it wasn't clear if that was because of the dedicated ambulance staffing, or to improvements made to reporting requirements, which had been delayed before the trial situation.

In addition, one of the hires, who had abundant ambulance experience but less firefighting experience, was sent to the firefighting academy for 16 weeks, and this had an impact on the ambulance program, Mr. Clark said.

The town has paramedic level responders.

Chief DiFronzo said the issue has become more difficult to handle as physicians and hospitals shift from consistently discharging patients between 9 a.m. and 2 p.m. Now, it appears they are discharging patients later in the afternoon, from 3 to as late as 6, he said.

“That's why we have this concern about how do we work to capture as many of these requests for service as we can,” he said.

He said the town needs to figure out the ambulance runner's availability, and create an incentive for them to come back and do the extra work.

Harrington Healthcare System President and CEO Edward H. Moore said Harrington tries to give priority to the ambulance company from the town where the patient lives, which increases opportunities for Southbridge, Charlton and Webster.

Webster has standalone nonprofit ambulance service.

Charlton EMS Coordinator Terri Gough said she did not know if its increased call volume could be attributed to transfer requests from the hospital system, which opened an MRI facility in 2009, and an accompanying medical office building a year later on North Main Street in Charlton.

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